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MU researcher develops new method of tracking ICU nurses’ workflow

Dots mark locations on a set of blueprints of an ICU.

The NEFR system, which includes several routers set up throughout the unit and wearable devices for the nurses, allows researchers to track nurses’ movements in real time. Photo courtesy of Jung Hyup Kim.

Jung Hyup Kim studies ways to make workplaces more efficient. And he recently developed a method of better tracking how nurses in a fast-paced intensive care unit (ICU) spend their workday.

Kim, an assistant professor in the MU Industrial and Manufacturing Systems Engineering Department, utilized a combination of manual observation and what’s called a Near Field Electromagnetic Ranging (NEFR) system to drill down a more accurate measure of how much time ICU nurses spend on various duties each day. He presented his research results at the Institute of Industrial and Systems Engineers (IISE) Conference earlier this year.

The data was collected at the ICU at University Hospital on the campus of the University of Missouri.

“The nurses in an ICU confront heavy workload every day and are facing difficulties in managing multiple stressors from their daily routine work,” Kim said. “They’re multitaskers. They have to do many things simultaneously. While talking, they do charting in the electronic medical record (EMR) system.”

Previous studies about nurse workflow analysis have used a time-motion study method, which involves manually observing nurses — in person or via video — and measuring how much time they spend on each task. The NEFR system, which includes several routers set up throughout the unit and wearable devices for the nurses, allows researchers to track nurses’ movements in real time.

This allows for greater accuracy because, in order to protect patients’ privacy, manual observation is not allowed in patient rooms. The NFER system allows researchers to see if nurses are providing patient care or inputting data during their time spent in each room. When they input data in the room, simple observation cannot tell how long the nurses spent on data and on the patient — simply how long they were in the room. The NFER system allowed Kim to pinpoint whether or not the nurses were at the room’s computer or bedside and measure time spent doing each accordingly.

The router/wearable device system is also non-intrusive, which allows for great data collection without impacting the nurses’ day-to-day activities.

“We knew when and where nurses were during their shift, and what kind of work they did in real time by using the data we collected from the NFER system. I believe it will advance our understanding of ICU nurses’ workflow,” Kim explained.

Going forward, Kim wants to expand the study to cover full 24-hour periods rather than just the day shift, as well as extend the method to other ICUs. His future goal of this research is to improve the healthcare delivery process in an ICU.